How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $56.23 | Facility | None | $10.72 | $10.72 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $11.48 | Professional | None | $10.72 | $10.72 | $11.48 |
AllWays Health Partners Setting Facility Modifier None Typical Low $20.42 Median $20.42 Typical High $60.26 | Facility | None | $20.42 | $20.42 | $60.26 |
AllWays Health Partners Setting Professional Modifier None Typical Low $7.59 Median $20.42 Typical High $35.48 | Professional | None | $7.59 | $20.42 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $23.99 | Professional | None | $16.98 | $16.98 | $23.99 |
Fallon Health Setting Facility Modifier None Typical Low $60.26 Median $100.00 Typical High $8,511.38 | Facility | None | $60.26 | $100.00 | $8,511.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $10.72 Median $17.78 Typical High $38.02 | Professional | None | $10.72 | $17.78 | $38.02 |
Mass General Brigham Setting Facility Modifier None Typical Low $20.42 Median $20.42 Typical High $60.26 | Facility | None | $20.42 | $20.42 | $60.26 |
Mass General Brigham Setting Professional Modifier None Typical Low $7.59 Median $20.42 Typical High $35.48 | Professional | None | $7.59 | $20.42 | $35.48 |
United Setting Professional Modifier None Typical Low $7.08 Median $20.89 Typical High $42.66 | Professional | None | $7.08 | $20.89 | $42.66 |
Well Sense Setting Facility Modifier None Typical Low $16.22 Median $21.88 Typical High $32.36 | Facility | None | $16.22 | $21.88 | $32.36 |
Well Sense Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $21.38 | Professional | None | $17.78 | $17.78 | $21.38 |
2 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.58 Median $1.58 Typical High $1.74 | Professional | 55 · Aftercare only | $1.58 | $1.58 | $1.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.07 Typical High $1.15 | Professional | 56 · Pre-op care only | $1.07 | $1.07 | $1.15 |
Where Massachusetts sits
The same service costs 3.5 times more in Florida than in Alabama. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Massachusetts· 14th of 51
$20.42
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.